Association of short-term and long-term weight loss with the risk of major adverse cardiovascular disease: Community-based cohort study

Hae Ryong Yun, Young Su Joo, Tae Ik Chang, Ea Wha Kang, Nak Hoon Son, Hyung Woo Kim, Jung Tak Park, Tae Hyun Yoo, Shin Wook Kang, Seung Hyeok Han

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Background: This study evaluated temporal association of changes in BMI over time with major adverse cardiovascular event (MACE) in Korean middle-aged adults. Methods: Between 2001 and 2002, 6855 individuals from the Korean Genome and Epidemiology Study were included and followed up until 2014. The main predictor was the change in BMI determined using group-based trajectory modelling (decreasing, stable, and increasing) from the baseline to 4-, 6-, and 8-years of follow-up. The primary outcome was the occurrence of MACE. Results: During the mean 10.2 years follow-up, MACEs occurred in 350 (5.1 %) individuals. The median (interquartile rage) age of study population was 50 (44–59) years. In primary analysis with 4-year trajectory model, decreasing BMI trajectory was associated with a 1.41-fold higher risk of the MACEs (hazard ratio [HR], 1.41; 95 % confidence interval [CI], 1.06–1.91) compared with stable BMI trajectory. In secondary analyses with 6- and 8-year trajectory models, this association disappeared, and the corresponding HRs (95 % CIs) were 1.14 (0.81–1.61) and 0.98 (0.65–1.49), respectively. There were concomitant improvements in cardiometabolic risk factors in decreasing BMI group, but unfavorable risk burden remained up to 4 to 6 years. Conclusions: The initial 4-year weight loss was paradoxically associated with a higher risk of MACEs, probably due to residual cardiovascular burden. However, this association became null in participants with sustained weight loss ≥ 6 years, suggesting a possible lag effect of weight loss on MACEs.

Original languageEnglish
Article number110193
JournalDiabetes Research and Clinical Practice
Publication statusPublished - 2023 Jan

Bibliographical note

Funding Information:
This study was supported by a faculty research grant of Yonsei University College of Medicine (6–2022-0059). And, also funded by the Ministry for Health and Welfare, Republic of Korea [4845‐301 and 4851‐302], the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (Grant No: HC15C1129). The funders of this study had no role in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the manuscript for publication.

Publisher Copyright:
© 2022 Elsevier B.V.

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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